Author's replyWe greatly appreciate your interest to our study and thank you for your comments. We agree that there are many variables which could affect injection pain. We believe that surgeons should be aware of this factor to minimize patient's pain. Our study was begun from this idea. 1 As your comment, injection solution's temperature and injection speed have impact on pain while giving LA injection. However, we are carefully concern about stability of buffered lidocaine when warming solution.In previous study, buffered lidocaine dropped to 66.1% of initial concentrations after 4 weeks when stored at 25°C. 2 We believe that when warming solution up to body temperature (36.5°C) would accelerate decline of concentration of buffered lidocaine. Therefore, we recommend to warm solution just before injection.The rate of administration of LA are very important factor affecting injection pain. However, we believe that speed of injection is only partial element of injection technique. It is important to consider multiple factor to minimize pain such as needle size, length, injection depth and direction, injection amount, etc. Therefore, we recommend to use "hole-in-one" injection technique which is introduced in our article. 1,3
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